Modular and cooperative medical devices and related systems and methods

ABSTRACT

The various embodiments disclosed herein relate to modular medical devices, including various devices with detachable modular components and various devices with pivotally attached modular components. Additional embodiments relate to procedures in which various of the devices are used cooperatively. Certain embodiments of the medical devices are robotic in vivo devices.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims priority to Provisional Application No.60/956,032, filed Aug. 15, 2007; Provisional Application No. 60/990,076,filed Nov. 26, 2007; Provisional Application No. 60/990,106, filed Nov.26, 2007; Provisional Application No. 61/025,346, filed Feb. 1, 2008;and Provisional Application No. 61/030,617, filed Feb. 22, 2008, all ofwhich are hereby incorporated herein by reference in their entireties.

GOVERNMENT SUPPORT

This invention was made with government support under Grant No.R21EB5663-2, awarded by the National Institute of Biomedical Imaging andBioengineering within the National Institutes of Health. Accordingly,the government has certain rights in the invention.

TECHNICAL FIELD

The embodiments disclosed herein relate to various medical devices andrelated components, including robotic and/or in vivo medical devices andrelated components. Certain embodiments include various modular medicaldevices, including modular in vivo and/or robotic devices. Otherembodiments relate to modular medical devices in which the variousmodular components are segmented components or components that arecoupled to each other. Further embodiment relate to methods of operatingthe above devices, including methods of using various of the devicescooperatively.

BACKGROUND

Invasive surgical procedures are essential for addressing variousmedical conditions. When possible, minimally invasive procedures such aslaparoscopy are preferred. However, known minimally invasivetechnologies such as laparoscopy are limited in scope and complexity duein part to 1) mobility restrictions resulting from using rigid toolsinserted through access ports, and 2) limited visual feedback. Knownrobotic systems such as the da Vinci® Surgical System (available fromIntuitive Surgical, Inc., located in Sunnyvale, Calif.) are alsorestricted by the access ports, as well as having the additionaldisadvantages of being very large, very expensive, unavailable in mosthospitals, and having limited sensory and mobility capabilities.

There is a need in the art for improved surgical methods, systems, anddevices.

SUMMARY

One embodiment disclosed herein relates to a modular medical device orsystem having at least one modular component configured to be disposedinside a cavity of a patient. The modular component has a body, anoperational component, and a coupling component. In a furtherembodiment, the modular component can be coupled at the couplingcomponent to a second modular component. In a further alternative, athird modular component can be coupled to the first and second modularcomponents.

Another embodiment disclosed herein relates to a modular medical deviceor system having a body configured to be disposed inside a cavity of apatient. The device also has at least a first modular componentcoupleable to the body, the first modular component having a firstoperational component. In another embodiment, the device also as asecond modular component coupleable to the body, the second modularcomponent having a second operational component. In furtheralternatives, the device can also have third and fourth modularcomponents or more.

Yet another embodiment disclosed herein relates to a modular medicaldevice or system having a first modular component, a second modularcomponent, and a third modular component. In one embodiment, the threemodular components are pivotally connected to each other in a triangularconfiguration. In this embodiment, the first and third components can becoupled together at a releasable mating connection. According to oneembodiment, each of the modular components has an inner body and anouter body, wherein the inner body is rotatable in relation to the outerbody. In addition, each modular component has an operational componentassociated with the inner body. In accordance with anotherimplementation, each of the inner and outer bodies comprise an opening,and each of the inner bodies is rotatable to position the inner andouter openings in communication, whereby the operational components areaccessible. In a further alternative, each pivotal connection of thedevice or system has a mechanism configured to urge the mating orcoupling connections at the ends of the first and third components intocontact. Alternatively, the device has four modular components that arepivotally connected to each other in a quadrangular configuration. Infurther alternatives, additional modular components can be pivotallyconnected to each other.

While multiple embodiments are disclosed, still other embodiments of thepresent invention will become apparent to those skilled in the art fromthe following detailed description, which shows and describesillustrative embodiments of the invention. As will be realized, theinvention is capable of modifications in various obvious aspects, allwithout departing from the spirit and scope of the present invention.Accordingly, the drawings and detailed description are to be regarded asillustrative in nature and not restrictive.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1A is a perspective view of a modular medical device, according toone embodiment.

FIG. 1B is a side view of the modular medical device of FIG. 1A.

FIG. 1C is a front view of the modular medical device of FIG. 1A.

FIG. 2A depicts a perspective view of a modular component, according toone embodiment.

FIG. 2B depicts a close-up perspective view of a portion of the modularcomponent of FIG. 2A.

FIG. 3 is a perspective view of another modular component, according toanother embodiment.

FIG. 4 is a front cutaway view of another modular component, accordingto a further embodiment.

FIG. 5A is a perspective view of a modular medical device controlsystem, according to one embodiment.

FIG. 5B is a front cutaway view of the system of FIG. 5A.

FIG. 6A is a perspective view of a modular medical device control andvisualization system, according to one embodiment.

FIG. 6B is a front cutaway view of the system of FIG. 6A.

FIG. 7A is a perspective cutaway view of a modular medical devicecontrol and visualization system, according to another embodiment.

FIG. 7B is a front cutaway view of the system of FIG. 7A.

FIG. 8A is a perspective view of a modular medical device, according toanother embodiment.

FIG. 8B is another perspective view of the device of FIG. 8A.

FIG. 9 is a perspective view of another modular medical device,according to a further embodiment.

FIG. 10 is a perspective view of a further modular medical device,according to another embodiment.

FIG. 11 is a perspective view of another modular medical device,according to one embodiment.

FIG. 12A is a perspective view of another modular medical device,according to a further embodiment.

FIG. 12B is a close-up perspective view of a part of the device of FIG.12A.

FIG. 12 C is another perspective view of the device of FIG. 12A.

FIG. 13 is a perspective view of a further modular medical device,according to another embodiment.

FIG. 14 is a perspective view of the disassembled components of anothermodular medical device, according to one embodiment.

FIG. 15 is a perspective view of the disassembled components of afurther modular medical device, according to another embodiment.

FIG. 16 is a perspective view of the disassembled components of afurther modular medical device, according to another embodiment.

FIG. 17 is a perspective view of an assembled modular medical device,according to a further embodiment.

FIG. 18A is a front view of a modular medical device with a payloadspace, according to one embodiment.

FIG. 18B is another front view of the device of FIG. 18A.

FIG. 19A is a perspective view of a modular medical device, according toanother embodiment.

FIG. 19B is a perspective bottom view of the device of FIG. 19A.

FIG. 20A is a perspective top view of the device of FIG. 19A.

FIG. 20B is a perspective side view of the device of FIG. 19A.

FIG. 20C is a perspective close-up view of a portion of the device ofFIG. 19A.

FIG. 21 is a perspective bottom view of the device of FIG. 19A.

FIG. 22 is a perspective side view of the device of FIG. 19A.

FIG. 23 is a top view of the device of FIG. 19A.

FIG. 24 is a perspective view of modular medical device control andvisualization system, according to one embodiment.

FIG. 25 is a perspective view of a modular medical device, according toone embodiment.

FIG. 26 is a perspective cutaway view of various medical devicesoperating cooperatively in a body cavity, according to one embodiment.

FIG. 27 is a perspective cutaway view of various medical devicesoperating cooperatively in a body cavity, according to anotherembodiment.

FIG. 28 is a perspective cutaway view of various medical devicesoperating cooperatively in a body cavity, according to a furtherembodiment.

DETAILED DESCRIPTION

The various systems and devices disclosed herein relate to devices foruse in medical procedures and systems. More specifically, variousembodiments relate to various modular or combination medical devices,including modular in vivo and robotic devices and related methods andsystems, while other embodiments relate to various cooperative medicaldevices, including cooperative in vivo and robotic devices and relatedmethods and systems.

It is understood that the various embodiments of modular and cooperativedevices and related methods and systems disclosed herein can beincorporated into or used with any other known medical devices, systems,and methods.

For example, the various embodiments disclosed herein can beincorporated into or used with any of the medical devices and systemsdisclosed in copending U.S. application Ser. Nos. 11/932,441 (filed onOct. 31, 2007 and entitled “Robot for Surgical Applications”),11/695,944 (filed on Apr. 3, 2007 and entitled “Robot for SurgicalApplications”), 11/947,097 (filed on Nov. 27, 2007 and entitled “RoboticDevices with Agent Delivery Components and Related Methods), 11/932,516(filed on Oct. 31, 2007 and entitled “Robot for Surgical Applications”),11/766,683 (filed on Jun. 21, 2007 and entitled “Magnetically CoupleableRobotic Devices and Related Methods”), 11/766,720 (filed on Jun. 21,2007 and entitled “Magnetically Coupleable Surgical Robotic Devices andRelated Methods”), 11/966,741 (filed on Dec. 28, 2007 and entitled“Methods, Systems, and Devices for Surgical Visualization and DeviceManipulation”), 12/171,413 (filed on Jul. 11, 2008 and entitled “Methodsand Systems of Actuation in Robotic Devices”), 60/956,032 (filed on Aug.15, 2007), 60/983,445 (filed on Oct. 29, 2007), 60/990,062 (filed onNov. 26, 2007), 60/990,076 (filed on Nov. 26, 2007), 60/990,086 (filedon Nov. 26, 2007), 60/990,106 (filed on Nov. 26, 2007), 60/990,470(filed on Nov. 27, 2007), 61/025,346 (filed on Feb. 1, 2008), 61/030,588(filed on Feb. 22, 2008), and 61/030,617 (filed on Feb. 22, 2008), allof which are hereby incorporated herein by reference in theirentireties.

Certain device implementations disclosed in the applications listedabove can be positioned within a body cavity of a patient, includingcertain devices that can be positioned against or substantially adjacentto an interior cavity wall, and related systems. An “in vivo device” asused herein means any device that can be positioned, operated, orcontrolled at least in part by a user while being positioned within abody cavity of a patient, including any device that is positionedsubstantially against or adjacent to a wall of a body cavity of apatient, further including any such device that is internally actuated(having no external source of motive force), and additionally includingany device that may be used laparoscopically or endoscopically during asurgical procedure. As used herein, the terms “robot,” and “roboticdevice” shall refer to any device that can perform a task eitherautomatically or in response to a command.

Certain implementations disclosed herein relate to modular medicaldevices that can be assembled in a variety of configurations.

FIGS. 1A-1C depict an exemplary “combination” or “modular” medicaldevice 10, according to one embodiment. For purposes of thisapplication, both “combination device” and “modular device” shall meanany medical device having modular or interchangeable components that canbe arranged in a variety of different configurations. The combinationdevice 10 shown in FIGS. 1A-1C has three modular components 12, 14, 16coupled or attached to each other. More specifically, the device 10 hastwo robotic arm modular components 12, 14 and one robotic camera modularcomponent 16 disposed between the other two components 12, 14. In thisimplementation, the modular component 16 contains an imaging component(not shown) and one or more lighting components (not shown), while eachof the other modular components 12, 14 have an arm 24, 26 respectivelyand do not contain any lighting or imaging components. That is, in thisembodiment, the modular component 16 is a modular imaging and lightingcomponent 16 while the two modular components 12, 14 are modular armcomponents 12, 14. In the resulting configuration, the components 12,14, 16 are coupled or attached to each such that the camera component 16is disposed between the two modular arm components 12, 14. As will bediscussed in further detail below, this configuration of the components12, 14, 16 is merely one of several possible configurations of suchmodular components.

In accordance with one embodiment, the strategic positioning of variousoperational components in the combination device 10 in FIGS. 1A-1Cresults in an optimization of the volume in each of the individualcomponents 12, 14, 16. That is, the space in modular components 12, 14that would have been required for an imaging component and/or a lightingcomponent is instead utilized for larger and/or more complex actuatorsor other components. If larger or more complex actuators are utilized inboth modular components 12, 14, greater force can be applied to each arm24, 26, thereby making it possible for the combination device 10 toperform additional procedures that require greater force.

In comparison to the space optimization advantage of the combinationdevice 10, a non-combination device must have all the necessarycomponents such as imaging and illumination components in the devicebody along with the actuators, thereby reducing the space available andrequiring that the actuators and other components be small enough suchthat they all fit in the device together.

According to one alternative embodiment, the additional space availablein the combination device 10 created by the space optimization describedabove could be used to provide for more sophisticated components such asmore complex camera focusing mechanisms or mechanisms to provide zoomcapabilities. In a further alternative, the various components could bedistributed across the modular components 12, 14, 16 of the combinationdevice 10 in any fashion. For example, the illumination and imagingcomponents could be both positioned in either modular component 12 or14. Alternatively, one of the illumination and imaging components couldbe disposed in any one of the three modular components 12, 14, 16 andthe other component could be disposed in one of the other threecomponents 12, 14, 16. It is understood that any possible combination ofvarious components such as illumination, actuation, imaging, and anyother known components for a medical device can be distributed in anycombination across the modular components of any combination device.

Another advantage of the combination devices such as that shown in FIGS.1A-1C, according to one implementation, is the capacity to increase thenumber of a particular type of component in the device. For example, oneembodiment of a combination device similar to the device 10 in FIGS.1A-1C could have lighting components on more than one of the modularcomponents 12, 14, 16, and further could have more than one lightingcomponent on any giving modular component. Thus, the combination devicecould have a number of lighting components ranging from one to anynumber of lighting components that could reasonably be included on thedevice. The same is true for any other component that can be included intwo or more of the modular components.

In accordance with a further embodiment, another possible advantage ofthe various combination device embodiments disclosed herein relates tothe fact that the various separable modular components (instead of onelarger device) simplifies insertion because each component separately isshorter and less complex. Thus, each component individually has asmaller cross-section and can be inserted into a body cavity through asmaller incision, port, or any other known delivery device than thelarger, non-combination device.

It is understood that, according to various embodiments, a combinationdevice such as the device 10 depicted in FIGS. 1A-1C could haveadditional modular components coupled thereto. Thus, the device couldhave additional arms or other modular components such as, for example,one or more of a sensing modular component, an illumination modularcomponent, and/or a suction/irrigation modular component.

In use, modular components (such as, for example, components 12, 14, 16of FIGS. 1A, 1B, and 1C) are each separately inserted into the targetcavity of a patient. Typically, each of the components are insertedthrough a laparoscopic port, an incision, or a natural orifice.Alternatively, the components are inserted by any known method,procedure, or device. Once each of the desired components (which couldrange from one to several components) is positioned in the targetcavity, the components can be assembled into a combination device suchas, for example, the combination device 10 depicted in FIGS. 1A-1C, bycoupling the components together in a desired configuration. After theprocedure has been performed, the components of the combination devicecan be decoupled and each separately removed. Alternatively, once aportion of a procedure is performed, one or more of the components canbe decoupled and removed from the cavity and one or more additionalcomponents can be inserted into the cavity and coupled to thecombination device for one or more additional procedures for which thecomponent replacement was necessary.

The various modular component embodiments disclosed herein can becoupled to create a combination device in a variety of ways. Toconfigure the combination device 10 as shown in FIG. 1A, the exemplarymodular components 12, 14, 16 each have four mating or couplingcomponents as best shown in FIGS. 2A, 2B, and 3.

In FIGS. 2A and 2B, the modular component 16 provides one example of anattachment mechanism for coupling modular components together. That is,the device 16 has four mating or coupling components 34A, 34B, 35A, (and35B, which is not shown) for coupling to other devices or modularcomponents. In this embodiment as best shown in FIG. 2A, there are twocoupling components 34, 35 at each end of the device 30, with twocomponents 34A, 34B at one end and two more at the other end (depictedas 35A and another such component on the opposite side of the component16 that is not visible in the figure). Alternatively, the modularcomponent 16 can have one coupling component, two coupling components,or more than two coupling components.

To better understand the coupling components of this embodiment, FIG. 2Bprovides an enlarged view of one end of the device 16, depicting themale coupling component 34A and female coupling component 34B. The malecomponent 34A in this embodiment is configured to be coupleable with acorresponding female component on any corresponding modular component,while the female component 34B is configured to be coupleable with acorresponding male component on any corresponding modular component.

It is understood that the mechanical male/female coupling componentsdiscussed above are merely exemplary coupling mechanisms. Alternatively,the components can be any known mechanical coupling components. In afurther alternative, the coupling components can also be magnets thatcan magnetically couple with other magnetic coupling components in othermodular components. In a further embodiment, the coupling components canbe a combination of magnets to help with initial positioning andmechanical coupling components to more permanently couple the twomodules.

Returning to the embodiment depicted in FIG. 1A, two modular components12, 14, each having an arm 24, 26 (respectively), are coupled to themodular component 16. FIG. 3 depicts component 12, but it is understoodthat the following discussion relating to modular component 12 appliesequally to component 14. Modular component 12 as shown in FIG. 3 hasmale/female coupling components 44, 45 that can be coupled to component16 as discussed above. Alternatively, as discussed above, any knowncoupling components can be incorporated into this component 12 forcoupling with other modular components.

According to one implementation, the arm 24 in the embodiment of FIG. 3provides the four degrees of freedom (“DOF”). These four degrees offreedom include three rotations and one extension. Two rotations occurabout the joint 42. The third rotation occurs along the axis of the arm24. The extension also occurs along the axis of the arm 24.Alternatively, any known arm implementation for use in a medical devicecan be used.

FIG. 4 depicts an alternative exemplary embodiment of modular component12. In this implementation, the actuator components 54A, 54B, 56A, 56Bare depicted in the component 12. That is, two actuators 54A, 54B areprovided in the body of the device 12, while two additional actuators56A, 56B are provided in the arm 24. According to one embodiment,actuators 54A, 54B are configured to actuate movement of the arm 24 atthe shoulder joint 58, while actuators 56A, 56B are configured toactuate movement at the arm 24. Alternatively, it is understood that anyconfiguration of one or more actuators can be incorporated into amodular component to actuate one or more portions of the component ordevice.

In accordance with further implementations, it is understood that thevarious modular components discussed herein can contain any knownoperational components contained in any non-modular medical device. Forexample, the modular component 16 has a camera 32 and further can haveall of the associated components and/or features of the modularcomponents or medical devices discussed above, including the medicaldevices and components disclosed in the applications incorporated above.

In the depicted embodiment, the modular component 16 has a connectioncomponent or “cable” 22 that can be connected at the other end of thecable 22 to a controller (not shown). Similarly, each of modularcomponents 12, 14 also can have a connection component (18, 20respectively). In alternative implementations, the combination device 10could have a single cable connected to one of the modular components. Insuch implementations, the coupling components also provide forcommunication connections among the modular components such that power,control signals or commands, video, and any other form of communicationcan be transported or communicated among the modular components.

In use, the various modular components and combination devices disclosedherein can be utilized with any known medical device control and/orvisualization systems, including those system disclosed in theapplications incorporated above. These modular components andcombination devices can be utilized and operated in a fashion similar toany medical devices disclosed in those applications. For example, asshown in FIGS. 5A and 5B, a combination device or modular component 60can be utilized with an external magnetic controller 62. In thisembodiment, the device 60 has magnetic components (not shown) that allowthe device 60 to be in magnetic communication with the externalcontroller 62. It is understood that the device 60 can operate inconjunction the external controller 62 in the same fashion described inthe applications incorporated above.

In an alternative use, any of the individual modular components canoperate as an independent device as well. That is, it is understood thatany individual component can be inserted into a body cavity and operatedwithout coupling it to any other modular components. As such, eachmodular component can also be considered a separate device.

In another similar example as depicted in FIGS. 6A and 6B, a combinationdevice or modular component 70 can be utilized with an externalcontroller and visualization component 72. In this embodiment, thedevice 70 has magnetic components (not shown) that allow the device 70to be in magnetic communication with the external controller 72 andfurther has arms 74A, 74B that can be operated using the controller 72.It is understood that the device 70 can operate in conjunction theexternal component 72 in the same fashion described in the applicationsincorporated above.

According to one implementation, a modular device can be used for avariety of surgical procedures and tasks including, but not limited to,tissue biopsy and tissue retraction. For example, as shown in FIGS. 7Aand 7B in accordance with one embodiment, a device 80 having a grasper82 can be used to retract the gall bladder 84 during a cholecystectomyprocedure.

In accordance with one alternative, any of the modular componentsdisclosed herein can be assembled into the combination device prior toinsertion into the patient's cavity. One exemplary embodiment of such acombination device is set forth in FIGS. 8A and 8B, which depict acombination device 120 having modular components 122A, 122B, 122C, 122D,122E that are coupled to each other using hinge or rotational joints124A, 124B, 124C, 124D, 124E (as best shown in FIG. 8B). This device 120as shown can fold together or otherwise be configured after insertion asshown in FIG. 8A. One advantage of this embodiment, in which the modularcomponents 122A-122E are coupled to each other, is that in vivo assemblyof the combination device 120 is simplified.

In a further alternative embodiment as best shown in FIG. 9, any of themodular components disclosed or contemplated herein are insertedseparately into the target cavity and subsequently assembled with themodular components being connected end-to-end (in contrast to aside-by-side configuration similar to that depicted in FIGS. 1A-1C).More specifically, the combination device 130 in FIG. 9 has threemodular components 132, 134, 136. One of the components is a cameramodular component 132, while the other two are robotic arm modularcomponents 134, 136. These three components 132, 136, 136 are connectedto form the tripod-like combination device 130 as shown.

In yet another implementation, FIG. 10 depicts another combinationdevice 140 having a generally triangular configuration. That is, thedevice 140 has three arm modular components 142, 144, 146 that arecoupled together end-to-end, with each component 142, 144, 146 having anarm 148, 147, 149, respectively. In one embodiment, the three-armedrobot could be assembled using three one-arm segments as shown in FIG.10. Alternatively, the three-armed robot could be assembled by linkingthree modular bodies end-to-end and coupling an arm component to eachlinkage of the modular bodies.

Alternatively, additional modular components could be added to atripod-like combination device such as the devices of FIGS. 9 and 10.For example, one or more additional modular components could bepositioned adjacent and parallel to one or more of the threepreviously-coupled modular components such that one or more side of thethree sides have a “stacked” configuration with at least two modularcomponents stacked next to each other.

As mentioned above, according to one embodiment, a particularly usefulaspect of using modular medical devices during medical procedures,including modular robotic and/or in vivo devices as described herein, isthe ability to insert multiple modular components, such as any of themodular components described or contemplated herein, into a patient'sbody and subsequently assemble these into a more complex combinationdevice in vivo. In one implementation, more than one modular componentis inserted or positioned in the patient's body (through a naturalorifice or more conventional methods) and then the components are eithersurgically assembled or self-assembled once inside the patient's body,in a location such as the peritoneal cavity, for example.

Surgical (or procedural) assembly can involve the surgeon attaching themodular components by using standard laparoscopic or endoscopic tools,or could involve the surgeon using specifically developed tools for thispurpose. Alternatively, surgical assembly could instead or furtherinclude the surgeon controlling a robotic device disposed within thepatient's body or exterior to the body to assemble the modularcomponents. Self assembly, on the other hand, can involve the modularcomponents identifying each other and autonomously assemblingthemselves. For example, in one embodiment of self assembly, the modularcomponents have infrared transmitters and receivers that allow eachcomponent to locate attachment points on other components. In anotherexample, each modular component has a system that utilizes imaging toidentify patterns on other modular components to locate attachmentpoints on those other components. In a further alternative, assemblycould also include both surgical and self-assembly capabilities.

After the surgical procedure is completed, the components aredisassembled and retracted. Alternatively, the robotic device or systemcan be configurable or reconfigurable in vivo to provide differentsurgical features during different portions of the procedure. That is,for example, the components of the device or devices can be coupledtogether in one configuration for one procedure and then disassembledand re-coupled in another configuration for another procedure.

One further exemplary embodiment of a suite of modular components is setforth in FIGS. 11-17. It is understood that such a suite of componentscan be made available to a surgeon or user, and the surgeon or user canutilize those components she or he desires or needs to create thecombination device desired to perform a particular procedure. In oneembodiment, since the devices and components are modular, the user (orteam) can assemble the procedure-specific robotic device or devices invivo at the onset of the procedure.

The modular components can include any known procedural or operationalcomponent, including any component discussed elsewhere herein (such asthose depicted in FIGS. 1A-4, and/or 8A-10) or any component disclosedin the applications incorporated above that can be used as modularcomponent. For example, the various modular components depicted in FIGS.11-17 include a variety of different operational components or othertypes of components.

More specifically, FIGS. 11-13 depict various modular combination deviceembodiments having a body that is coupled to at least one arm componentand a lockable tube. For example, FIG. 11 shows a combination device 150having a body 152 coupled to three operational arm components 154A,154B, 154C, and a lockable tube 156. In one aspect, the body 152 canalso have at least one magnet 158 (or two magnets as depicted in thefigure) that can be used to position the device within the patient'scavity. That is, according to one implementation similar to thosedescribed above in relation to other devices, the magnet(s) 158 can bemagnetically coupled to an external magnet controller or visualizationcomponent to position the device 150.

The lockable tube 156 can be a reversibly lockable tube as disclosed inU.S. application Ser. No. 12/171,413, filed on Jul. 11, 2008, which isincorporated by reference above. The tube 156 and device 150 can beoperated in any fashion as described in that application. Alternatively,the tube 156 can be a flexible tube that can be stabilized or held inplace using a series of magnets adjacent to or near the flexible tube ora series of needles inserted through the external wall of the patient'sbody. For example, magnets can be positioned in one or more of themodular components of the flexible tube. In use, one or more magnets arepositioned externally with respect to the target cavity in such afashion as to position the tube and/or robotic device into the desiredlocation.

In use, as also described in the above-incorporate application, areversibly lockable tube and robotic device (such as, for example, thetube 156 and device 150 depicted in FIG. 11) can be used together toaccomplish various tasks. That is, the tube can be operably coupled tothe device (as shown in FIG. 11, for example) and contain any requiredconnection components such as connections for hydraulic, pneumatic,drive train, electrical, fiber optic, suction, or irrigation systems, orany other systems or connections that require physical linkages betweenthe device positioned in the patient's body and some external componentor device. In one embodiment, the robotic device is first positioned atthe desired location in the patient's body and then the tube is insertedand connected to the device. Alternatively, the robotic device can becoupled to the tube prior to insertion, and then both the device and thetube are inserted into the patient's body and the device is thenpositioned at the desired location.

FIGS. 12A-12C depict another embodiment of a combination device coupledto a lockable tube. More specifically, FIGS. 12A, 12B, and 12C depict acombination device 160 having a body 162 coupled to one operational armcomponent 164 and a lockable tube 166. As with the device in FIG. 11,the body 162 has two magnets 168 that can be used in conjunction with anexternal magnet controller to position the device 160 and tube 166 asdesired by the user. Alternatively, the body 162 can have one magnet ormore than two magnets. In addition, according to one embodiment as bestshown in FIG. 12A, the device 160 and the tube 166 can be initiallyunattached. Prior to use, the body 162 and tube 166 can be coupled asbest shown in FIG. 12B. In one embodiment, the body 162 and tube 166 canbe coupled prior to insertion or alternatively can be coupled after thedevice 160 and tube 166 have been positioned in the desired location inthe patient's body.

FIG. 13 shows another embodiment of another combination device 170similar to those depicted in FIGS. 11-12C except that the body 172 iscoupled to the tube 174 at a location along the body 172 rather than atan end of the body 172. It is further understood that a tube asdisclosed herein can be coupled to any of these combination devices atany point along the body or any of the modular components.

Another example of a combination device that is made up a suite ofmodular components is set forth in FIG. 14. The combination device 180has an imaging modular component 182 (also referred to as a “module”),two cautery arms or modules 184A, 184B, and two grasper arms or modules186A, 186B. It is understood that the imaging module 182 in thisembodiment is the body 182 of the device 180, but could also be an armin another implementation. It is further understood that the variousmodules 184, 186 coupled to the device 180 could be configured in anyconfiguration.

An alternative combination device embodiment utilizing various modulesfrom a suite of modular components is depicted in FIG. 15. This device190 has an imaging module 192, a cautery module 194, a grasper module196, and a lighting module 198. Similarly, FIG. 16 depicts yet anotheralternative combination device 200 having an imaging module 202, alighting module 204, a cautery module 206, and two grasper modules 208.

FIG. 17 depicts a further alternative implementation of a fullyassembled combination device 210 having a body 212, two cautery modules214A, 214B, and two grasper modules 216A, 216B. As shown in the figure,each of the modules is coupled to the body via a hinge coupling 218A,218B, 218C, 218D. Alternatively, the coupling can be any known coupling,including, for example, a pivotal coupling. In a further alternative,the non-arm modules can be substantially or removably fixed to the bodycomponent, such as the lighting module 204 depicted in FIG. 16.

It is understood that any number of additional exemplary modularcomponents could be included in the suite of modular componentsavailable for use with these devices. For example, various additionalexemplary modules include, but are not limited to, an imaging module, asensor module (including a pH, humidity, temperature, and/or pressuresensor), a stapler module, a UV light module, an X-ray module, a biopsymodule, or a tissue collection module. It is understood that “module” isintended to encompass any modular component, including an arm or a bodyas discussed above.

In one embodiment, the mechanical and electrical couplings between themodular robotic sections are universal to help facilitate ease ofassembly. That is, the couplings or connections are universal such thatthe various modules can be easily and quickly attached or removed andreplaced with other modules. Connections can include friction fits,magnets, screws, locking mechanisms and sliding fitting. Alternatively,the connections can be any known connections for use in medical devices.In use, the couplings can be established by the surgeon or useraccording to one implementation. Alternatively, the couplings can besemi-automated such that the components are semi-self-assembling toimprove timeliness.

Modular components need not be arms or other types of components havingoperational components or end effectors. According to variousalternative embodiments, the modular components can be modularmechanical and electrical payload packages that can be used together invarious combinations to provide capabilities such as obtaining multipletissue samples, monitoring physiological parameters, and wirelesscommand, control and data telemetry. It is understood that the modularpayload components can be incorporated into all types of medicaldevices, including the various medical devices discussed andincorporated herein, such as magnetically controllable devices and/orwheeled devices similar to those disclosed in the applicationsincorporated above.

FIG. 18A shows one embodiment of a device 220 having a payload area 222that can accommodate various modular components such as environmentalsensors, biopsy actuator system, and/or camera systems. Morespecifically, the payload area 222 is configured to receive any one ofseveral modular components, including such components as the sensor,controller, and biopsy components discussed herein. It is understoodthat in addition to the specific modular components disclosed herein,the payload areas of the various embodiments could receive any knowncomponent to be added to a medical procedural device.

It is further understood that the robotic device having the payload areacan be any known robotic device, including any device that is positionedsubstantially adjacent to or against a patient cavity wall (such as viamagnetic forces), and is not limited to the robotic devices described indetail herein. Thus, while the robotic device embodiments depicted inFIGS. 18A and 18B (discussed below) are mobile devices having wheels,the various modular components described herein could just as readily bepositioned or associated with a payload area in any other kind ofrobotic device or can further be used in other medical devices andapplications that don't relate to robotic devices.

Returning to FIG. 18A, in this embodiment, the device is not tetheredand is powered by an onboard battery 224. Commands can be sent to andfrom the device using an RF transceiver placed on a circuit board 226.Alternatively, the device 220 can be tethered and commands and power canbe transmitted via the tether.

In the embodiment of FIG. 18A, the wheels 228A and 228B are powered byonboard motors 230A and 230B. Alternatively, the wheels 228A, 228B andother components can be actuated by any onboard or external actuationcomponents. The wheels 228 in this implementation are connected to themotors 230 through a bearing 232 and a set of spur gears 234 and 236.Alternatively, any known connection can be used. The use of independentwheels allows for forward, reverse, and turning capabilities. In thisembodiment, a small retraction ball 238 is attached to the outside ofeach wheel for retraction using a surgical grasper. Alternatively, noretraction component is provided. In a further alternative, any knownretraction component can be included.

FIG. 18B shows yet another embodiment of a device 240 having a payloadarea 242. In this embodiment, the modular component in the payload area242 is a sensor component. It is further understood that, according tovarious other implementations, more than one modular component can bepositioned in the payload area 242 of this device 240 or any otherdevice having a payload area. For example, the payload area 242 couldinclude both a biopsy component and a sensor component, or both a biopsycomponent and a controller component. Alternatively, the payload area242 could include any combination of any known functional components foruse in procedural devices.

In accordance with one implementation, one component that can beincluded in the payload area 242 is a sensor package or component. Thesensor package can include any sensor that collects and/or monitors datarelating to any characteristic or information of interest. In oneexample, the sensor package includes a temperature sensor.Alternatively, the package includes an ambient pressure sensor thatsenses the pressure inside the body cavity where the device ispositioned. In a further alternative, the package can include any one ormore of a relative humidity sensor, a pH sensor, or any other known typeof sensor for use in medical procedures.

The modular components and combination devices disclosed herein alsoinclude segmented triangular or quadrangular-shaped combination devices.These devices, which are made up of modular components (also referred toherein as “segments”) that are connected to create the triangular orquadrangular configuration, can provide leverage and/or stability duringuse while also providing for substantial payload space within the devicethat can be used for larger components or more operational components.As with the various combination devices disclosed and discussed above,according to one embodiment these triangular or quadrangular devices canbe positioned inside the body cavity of a patient in the same fashion asthose devices discussed and disclosed above.

FIGS. 19A-24 depict a multi-segmented medical device 250, in accordancewith one implementation. According to one embodiment, the device 250 isa robotic device 250 and further can be an in vivo device 250. Thisdevice embodiment 250 as shown includes three segments 252A, 252B, 254.Segments 252A and 252B are manipulator segments, while segment 254 is acommand and imaging segment. Alternatively, the three segments can beany combination of segments with any combination of components andcapabilities. For example, according to an alternative embodiment, thedevice could have one manipulator segment, one command and imagingsegment, and a sensor segment. In a further alternative, the varioussegments can be any type of module, including any of those modulesdescribed above with respect to other modular components discussedherein.

As best shown in FIGS. 19A and 19B, segments 252A, 252B are rotatablycoupled with the segment 254 via joints or hinges 256A, 256B. Morespecifically, segment 252A is rotatable relative to segment 254 aboutjoint 256A around an axis as indicated by arrow B in FIG. 19B, whilesegment 252B is rotatable relative to segment 254 about joint 256Baround an axis as indicated by arrow C in FIG. 19B.

In accordance with one embodiment, the device 250 has at least twoconfigurations. One configuration is an extended or insertionconfiguration as shown in FIG. 19A in which the three segments 252A,252B, 254 are aligned along the same axis. The other configuration is atriangle configuration as shown in FIG. 19B in which the manipulatorsegments 252A, 252B are each coupled to the segment 254 via the joints256A, 256B and further are coupled to each other at a coupleableconnection 258 at the ends of the segments 252A, 252B opposite thejoints 256A, 256B.

As best shown in FIG. 20A, each of the manipulator segments 252A, 252Bin this particular embodiment has an operational arm 260, 262(respectively). Each arm 260, 262 is moveably coupled to its respectivesegment 252A, 252B at a joint 264A, 264B (respectively) (as best shownin FIG. 22). Further, segment 254 has a pair of imaging components (eachalso referred to herein as a “camera”) 266A, 266B (as best shown in FIG.21).

In one embodiment, each arm 260, 262 is configured to rotate at itsjoint 264A, 264B in relation to its segment 252A, 252B to move betweenan undeployed position in which it is disposed within its segment 252A,252B as shown in FIG. 19B and a deployed position as shown in FIG. 20A.In one example, arm 260 is rotatable relative to segment 252A aboutjoint 264A in the direction shown by G in FIG. 22, while arm 262 isrotatable relative to segment 252B about joint 264B in the directionshown by H in FIG. 22. Alternatively, the arms 260, 262 are moveable inrelation to the segments 252A, 252B in any known fashion and by anyknown mechanism.

According to one embodiment as best shown in FIG. 20A, each arm 260, 262has three components: a proximal portion 260A, 262A, a distal portion260B, 262B, and an operational component 260C, 262C coupled with thedistal portion 260B, 262B, respectively. In this embodiment, the distalportion 260B, 262B of each arm 260, 262 extends and retracts along thearm axis in relation to the proximal portion 260A, 262A while alsorotating around that axis in relation to the proximal portion 260A,262A. That is, distal portion 260B of arm 260 can move back and forthlaterally as shown by the letter K in FIG. 22 and further can rotaterelative to the proximal portion 260A as indicated by the letter J,while distal portion 262B of arm 262 can move back and forth laterallyas shown by the letter L in FIG. 22 and further can rotate relative tothe proximal portion 262A as indicated by the letter I.

In accordance with one implementation, the operational components 260C,262C (also referred to herein as “end effectors”) depicted in FIG. 20Aare a grasper 260C and a cautery hook 262C. It is understood that theoperational component(s) used with the device 250 or any embodimentherein can be any known operational component for use with a medicaldevice, including any of the operational components discussed above withother medical device embodiments and further including any operationalcomponents described in the applications incorporated above.Alternatively, only one of the two arms 260, 262 has an operationalcomponent. In a further alternatively, neither arm has an operationalcomponent.

Alternatively, each arm 260, 262 comprises one unitary component or morethan two components. It is further understood that the arms 260, 262 canbe any kind of pivotal or moveable arm for use with a medical devicewhich may or may not have operational components coupled or otherwiseassociated with them. For example, the arms 260, 262 can have astructure or configuration similar to those additional arm embodimentsdiscussed elsewhere herein or in any of the applications incorporatedabove. In a further alternative, the device 250 has only one arm. In afurther alternative, the device 250 has no arms. In such alternativeimplementations, the segment(s) not having an arm can have othercomponents associated with or coupled with the segment(s) such assensors or other types of components that do not require an arm foroperation.

As discussed above, the segment 254 of the embodiment depicted in FIG.21 has a pair of cameras 266A, 266B. Alternatively, the segment 254 canhave a single camera or more than two cameras. It is understood that anyknown imaging component for medical devices, including in vivo devices,can be used with the devices disclosed herein and further can bepositioned anywhere on any of the segments or on the arms of thedevices.

In a further embodiment, the segment 254 as best shown in FIG. 21 canalso include a lighting component 268. In fact, the segment 254 has fourlighting components 268. Alternatively, the segment 254 can have anynumber of lighting components 268 or no lighting components. In afurther alternative, the device 250 can have one or more lightingcomponents positioned elsewhere on the device, such as one or both ofsegments 252A, 252B or one or more of the arms, etc.

In accordance with a further embodiment as best shown in FIGS. 19B and21, each of the segments 252A, 252B, 254 has two cylindricalcomponents—an outer cylindrical component and an inner cylindricalcomponent—that are rotatable in relation to each other. Morespecifically, the segment 252A has an outer cylindrical component 270Aand an inner cylindrical component 270B that rotates relative to theouter component 270A around an axis indicated by arrow F in FIG. 21.Similarly, the segment 252B has an outer cylindrical component 272A andan inner cylindrical component 272B that rotates relative to the outercomponent 272A around an axis indicated by arrow E in FIG. 21. Further,the segment 254 has an outer cylindrical component 274A and an innercylindrical component 274B that rotates relative to the outer component274A around an axis indicated by arrow D in FIG. 21.

In use, the embodiments having rotatable cylindrical components asdescribed in the previous paragraph can provide for enclosing any arms,cameras, or any other operational components within any of the segments.Further, any segment having such rotatable components provide for twosegment configurations: an open configuration and a closedconfiguration. More specifically, segment 252A has an outer cylindricalcomponent 270A with an opening 276 as shown in FIG. 21 through which thearm 260 can move between its deployed and undeployed positions.Similarly, segment 252B has an outer cylindrical component 272A with anopening 278 as shown in FIG. 21 through which the arm 262 can movebetween its deployed and undeployed positions. Further, segment 254 hasan outer cylindrical component 274A with an opening 280 as shown in FIG.21 through which the imaging component(s) 266A, 266B can capture imagesof a procedural or target area adjacent to or near the device 250.

FIG. 19B depicts the segments 252A, 252B, 254 in their closedconfigurations. That is, each of the inner cylindrical components 270B,272B, 274B are positioned in relation to the respective outercylindrical component 270A, 272A, 274A such that each opening 276, 278,280, respectively, is at least partially closed by the inner component270B, 272B, 274B such that the interior of each segment 252A, 252B, 254is at least partially inaccessible from outside the segment.

More specifically, in the closed position, inner cylindrical component270B of segment 252A is positioned in relation to outer cylindricalcomponent 270A such that the arm 260 is at least partially enclosedwithin the segment 252A. According to one embodiment, the innercylindrical component 270B is configured such that when it is in theclosed position as shown in FIG. 19B, it closes off the opening 276entirely. In a further embodiment, the inner cylindrical component 270Bin the closed position fluidically seals the interior of the segment252A from the exterior.

Similarly, in the closed position, inner cylindrical component 272B ofsegment 252B is positioned in relation to the outer cylindricalcomponent 272A such that the arm 262 is at least partially enclosedwithin the segment 252B. According to one embodiment, the innercylindrical component 272B is configured such that when it is in theclosed position as shown in FIG. 19B, it closes off the opening 278entirely. In a further embodiment, the inner cylindrical component 272Bin the closed position fluidically seals the interior of the segment252B from the exterior.

Further, in the closed position, inner cylindrical component 274B ofsegment 254 is positioned in relation to the outer cylindrical component274A such that the imaging component(s) is not positioned within theopening 280. According to one embodiment, the inner cylindricalcomponent 274B is configured such that when it is in the closed positionas shown in FIG. 19B, the imaging component(s) and any lightingcomponent(s) are completely hidden from view and not exposed to theexterior of the segment 254. In a further embodiment, the innercylindrical component 274B in the closed position fluidically seals theinterior of the segment 254 from the exterior.

In contrast, FIGS. 20A and 21 depict the segments 252A, 252B, 254 intheir open configurations. In these configurations, each of the innercylindrical components 270B, 272B, 274B are positioned such that theopenings 276, 278, 280 are open.

In use, according to one embodiment, the inner cylindrical components270B, 272B, 274B can thus be actuated to move between their closed andtheir open positions and thereby convert the device 250 between a closedor non-operational configuration (in which the operational componentssuch as the arms 260, 262 and/or the imaging components 266 and/or thelighting components 268 are inoperably disposed within the segments252A, 252B, 254) and an open or operational configuration (in which theoperational components are accessible through the openings 276, 278, 280and thus capable of operating). Thus, according to one implementation,the device 250 can be in its closed or non-operational configurationduring insertion into a patient's body and/or to a target area and thencan be converted into the open or operational configuration by causingthe inner cylindrical components 270B, 272B, 274B to rotate into theopen configurations.

Alternatively, one or more or all of the segments do not have inner andouter components that rotate in relation to each other.

It is understood that the various embodiments of the device 250disclosed herein include appropriate actuation components to generatethe force necessary to operate the arms and/or the rotatable cylindersin the segments. In one embodiment, the actuation components are motors.For example, segment 252A has a motor (not shown) operably coupled withthe arm 260 and configured to power the movements of the arm 260.Similarly, segment 252B also has a motor (not shown) operably coupledwith the arm 262 and configured to power the movements of the arm 260.In further embodiments, each of the segments 252A, 252B, 254 also havemotors (not shown) operably coupled to one or both of the inner andouter cylinder of each segment to power the rotation of the cylinders inrelation to each other. In one embodiment, each segment can have onemotor to power all drivable elements (arms, cylinders, etc.) associatedwith that segment. Alternatively, a separate motor can be provided foreach drivable element.

In one embodiment, the joints 256A, 256B are configured to urge thesegments 252A, 252B from the insertion configuration of FIG. 19A intothe triangular configuration of FIG. 19B. That is, the joints 256A, 256Bhave torsion springs or some other known mechanism for urging thesegments 252A, 252B to rotate around their joints 256A, 256B. Forexample, FIG. 20C depicts one embodiment in which the joint 256A hastorsion springs 282 that are configured to urge segment 252A toward thetriangular configuration.

In use, in accordance with one implementation, the device 250 in theinsertion configuration as shown in FIG. 19A can be inserted into apatient's body through an incision, a trocar port, or natural orifice inthe direction indicated by arrow A. Alternatively, the device 250 can beinserted in the other direction as well. After insertion and/or as thedevice 250 enters the target area or procedural area in the patient'sbody, the joints 256A, 256B with the torsion springs (or other standardmechanisms) urge the segments 252A, 252B from their insertion positionto their triangular position. As the segments 252A, 252B contact eachother to form joint 258, the two segments are coupled together withmating components that semi-lock the segments 252A, 252B together. Thatis, the two segments 252A, 252B can only be separated at the joint 258by a force sufficient to overcome the semi-lock. Any such known matingcomponent or coupling component, including any mechanical or magneticmating component(s), can be incorporated into the device 250 for thispurpose.

Thus, according to one embodiment, the device 250 can be in itsinsertion configuration during insertion into the patient. As the device250 enters the target cavity and exits the port or incision, the torsionsprings or other mechanisms at the joints 256A, 256B cause the twosegments 252A, 252B to move toward each other until they couple to formthe triangular configuration. The device 250 can then be attached to theabdominal wall by some method such as an external magnetic handle.Alternatively, the device 250 can be positioned anywhere in the cavityof the patient as desired by the user. The device 250 is then used toperform some sort of procedure.

Subsequently, when the procedure is complete, the device 250 can beretracted from the cavity. To do so, the surgeon uses a grasping orretrieval tool such as a Endo Babcock grasper made by Covidien inMansfield, Mass., to attach to or otherwise grasp the ball 284 at thejoint 258 and apply sufficient force to overcome the semi-lock of thejoint 258. Alternatively, any retrieval component can be positioned atthe end of segment 252A or elsewhere on the device 250 for grasping orotherwise coupling to for purposes of removing the device 250 from thepatient's body. When the coupling of the semi-lock is overcome, theforce urges the segments 252A, 252B away from each other, thereby makingit possible for the surgeon to pull the ball 284 through a port orincision and out of the patient, thereby forcing the device 250 into itsinsertion configuration.

The multiple segments provided in the various embodiments of the devicedisclosed herein result in significantly more payload space than asingle cylindrical body. The increased payload space results inincreased capabilities for the device in the form of more, bigger, ormore complex operational components, more, bigger, or more complexmotors, magnets (as described below) and other similar benefits relatingto the availability of more space for more, bigger, or more complexcomponents. For example, FIG. 20B depicts a side view of the device 250according to one embodiment that shows the payload space available insegment 252B. More specifically, segment 252B and its coupled arm 262have payload spaces 286, 288, 290, 292, 294 that can be used toaccommodate motors, operational components, sensors, magnets (asdescribed below) or any other type of component that could be useful fora procedural device. Similarly, each segment 252A, 252B, 254 can havesuch payload spaces. In addition, the segments 252A, 252B, 254 allow formaximization of the payload space available across the segments 252A,252B, 254 by distributing the components such as motors, operationalcomponents, or magnets to maximize their effectiveness while minimizingthe amount of space required by each such component. For example, itmight maximize effectiveness of the device 250 while minimizing theutilized space to have one large motor in one segment that providesforce for operation of components in more than one segment.

It is understood that various embodiments of the segmented devicesdisclosed herein are in vivo devices that can be inserted into andpositioned within a patient's body to perform a procedure. In oneembodiment, an external controller is also provided that transmitssignals to the device 250 to control the device 250 and receives signalsfrom the device 250. In one embodiment, the controller communicates withthe device 250 wirelessly. Alternatively, the controller and the device250 are coupled via a flexible communication component such as a cord orwire (also referred to as a “tether”) that extends between the device250 and the controller.

It is also understood that various embodiments of the devices disclosedherein can be used in conjunction with known attachment components toattach or otherwise position the device near, against, or adjacent to aninterior cavity wall inside the patient. In one embodiment, theattachment components are one or more magnets, disposed within thedevice, that communicate magnetically with one or more magnetspositioned outside the patient's body. The device magnets can bepositioned on or in the device in any suitable configuration. Forexample, the device magnets in one embodiment can be positioned withinthe segments 252A, 252B, 254 at positions 296, 298, 300 as shown in FIG.23. It is understood that the external magnets can be used outside thebody to position and/or move the device 250 inside the body.

It is further understood that various embodiments of the devicesdisclosed herein can be used in conjunction with known visualization andcontrol components, such as the console 310 depicted in FIG. 24. Theconsole 310 has a display 312 and magnets 314 and is positioned outsidethe patient such that the magnets 314 can be in magnetic communicationwith the device magnets (not shown) disposed within or otherwise coupledwith the device 250. The console 310 can be used to move the device 250by moving the console 310 outside the body such that the device 250 isurged to move inside the body, because the console magnets 250 aremagnetically coupled with the device magnets (not shown) within thedevice 250 such that the device 250 remains substantially fixed inrelation to the console 310. In addition, it is understood that thetriangular (and quandrangular) devices disclosed and described inrelation to FIGS. 19A-25 can be used in conjunction with any of theexternal controller or visualization components and systems disclosedand discussed above and in the applications incorporated above.

The segmented device 250, according to one embodiment, provides greaterstability and operability for the device 250 in comparison to other invivo devices. That is, a device having more than one segment such asdevice 250 provides for a configuration with a larger “footprint” forthe device 250, thereby resulting in greater stability and leverageduring use of the device 250. For example, the device 250 with thetriangular configuration in FIG. 24 that is urged against the interiorcavity wall of the patient by the console magnets 314 has greaterstability and leverage in comparison to a device that has a smaller“footprint.” That is, the device 250 can have at least three magnets(not shown) disposed at the three corners of the triangularconfiguration such that when the device 250 is magnetically positionedagainst the interior cavity wall, the arms of the device 250 can applygreater force to the target tissues while maintaining the position ofthe device 250 than a corresponding single cylindrical device body.

It is understood that the device embodiments disclosed herein are notlimited to a triangular configuration. FIG. 25 depicts a device 320having a quadrangular configuration with four segments. Similarly,devices are contemplated herein having any number of segments rangingfrom two segments to any number of segments that can be used for adevice that can be positioned inside a patient's body. For example, adevice incorporating the components and structures disclosed hereincould have six or eight segments or more.

In accordance with one embodiment, the various medical devices disclosedherein and in the applications incorporated above can be usedcooperatively. That is, two or more devices can be used at the same timeduring the same procedure to accomplish more or perform the proceduremore quickly than when only one device is used at a time. As such,multiple robots (more than one device and up to any number capable ofbeing inserted into a patient's cavity and present in the cavity at thesame time for performing one or more procedures) are inserted into thepatient's cavity and each controlled by the surgical team.

FIGS. 26-28 depict three different embodiments of cooperative use of twoor more medical devices together. In FIG. 26, the devices that arepositioned with a cavity of a patient include a device with operationalarms 330, two lighting devices 332A, 332B, and a cylindrical devicehaving a winch component with an end effector 334. These devices can beoperated at the same time using one or more external controllers and/orvisualization components according to the various embodiments disclosedabove or in the applications incorporated above.

Similarly, FIG. 27 depicts a cooperative procedure implementation usinga cylindrical device having a winch component with an end effector 340,a lighting device 342, and a cylindrical device 344. The cylindricaldevice 344 can have an imaging component and/or additional operationalcomponents such as sensors, etc.

Another embodiment is depicted in FIG. 28, in which a cooperativeprocedure is performed using a device with arms 350 and a lightingdevice 352.

According to one embodiment, the devices are assembled while beingintroduced through a natural orifice, a port, or an incision. Forinstance, if insertion is through the esophagus, each robot is inserteddown the overtube, which provides an “in line” ability for consistentassembly as each robot is “pushed” down the overtube. Alternatively,after insertion into the abdominal cavity, a camera and tool can beinserted to assist with the mechanical connections, or other roboticdevices can be used to help with the mechanical connections.

The level of cooperation amongst two or more in vivo medical devicesvaries between high network communications, planning, and some autonomy,to lower level mechanical connections and surgeon control. That is, incertain embodiments, the cooperative devices can communicate with eachother and perform with some level of autonomy (without input or withlimited input from the user or surgeon). In an alternativeimplementation, the cooperative devices can simply be positioned in thesame general procedural space and separately controlled by one or moreusers to work cooperatively to perform a procedure or procedures.

In one embodiment, two or more devices positioned in a body cavity canbe coupled to each other in some fashion. It is understood that thecoupling does not necessarily result in a rigidly coupling of thedevices to each other in all degrees. As such, the configuration(s) oftwo or more devices may adapt to the varying geometry of each patient,disturbances to the abdominal wall, and respiration cycle. According toone implementation, one benefit of coupling the devices is to maintain aset distance between the devices for vision, lighting, tissuemanipulation, and other procedural purposes.

Although the present invention has been described with reference topreferred embodiments, persons skilled in the art will recognize thatchanges may be made in form and detail without departing from the spiritand scope of the invention.

1. A modular medical device system, the system comprising: (a) a firstmodular component configured to be disposed inside a cavity of apatient, the first modular component comprising: (i) a first body; (ii)a first operational component associated with the first body; and (iii)at least one first coupling component associated with the first body;and (b) a second modular component configured to be disposed inside acavity of a patient, the second modular component comprising: (i) asecond body; (ii) a second operational component operably coupled to thesecond body; and (iii) at least one second coupling component associatedwith the second body, the at least one second coupling componentconfigured to be coupleable with the at least one first couplingcomponent.
 2. The system of claim 1, wherein the first operationalcomponent is chosen from a group consisting of an imaging component, anoperational arm component, a sensor component, and a lighting component.3. The system of claim 1, wherein the second operational component ischosen from a group consisting of an imaging component, an operationalarm component, a sensor component, and a lighting component.
 4. Thesystem of claim 1, further comprising a third modular componentconfigured to be disposed inside a cavity of a patient, the thirdmodular component comprising: (a) a third body; (b) a third operationalcomponent operably coupled to the third body; and (c) at least one thirdcoupling component associated with the third body, the at least onethird coupling component configured to be coupleable with the at leastone first coupling component and the at least one second couplingcomponent.
 5. The system of claim 4, wherein the third operationalcomponent is chosen from a group consisting of an imaging component, anoperational arm component, a sensor component, and a lighting component.6. The system of claim 4, wherein the first modular component isdisposed between the second and third modular components, wherein thefirst operational component comprises an imaging component, wherein thesecond and third operational components comprise operational armcomponents.
 7. The system of claim 4, wherein the first, second, andthird modular components are coupled in a substantially triangularconfiguration, wherein the first operational component comprises animaging component, wherein the second and third operational componentscomprise operational arm components.
 8. A modular medical device systemcomprising: (a) a body configured to be disposed inside a cavity of apatient; (b) a first modular component coupleable to the body at a firstlocation and configured to be disposed inside the cavity of the patient,the first modular component comprising a first operational component;and (c) a second modular component coupleable to the body at a secondlocation and configured to be disposed inside the cavity of the patient,the second modular component comprising a second operational component.9. The device of claim 8, further comprising a third modular componentcoupleable to the body at a third location and configured to be disposedinside the cavity of the patient, the third modular component comprisinga third operational component.
 10. The device of claim 9, furthercomprising a fourth modular component coupleable to the body at a fourthlocation and configured to be disposed inside the cavity of the patient,the fourth modular component comprising a fourth operational component.11. The system of claim 10, wherein the first, second, third, and fourthoperational components are all separately chosen from a group consistingof an imaging component, an operational arm component, a sensorcomponent, and a lighting component.
 12. A segmented medical device, thesystem comprising: (a) a first body segment configured to be disposedinside a cavity of a patient, the segment comprising: (i) a first outerbody; (ii) a first inner body rotatably disposed within the first outerbody; (iii) a first operational component associated with the firstinner body; and (iv) a first end of the first outer body comprising afirst mating component; (b) a second body segment configured to bedisposed inside a cavity of a patient, the segment comprising: (i) asecond outer body; (ii) a second inner body rotatably disposed withinthe second outer body; (iii) a second operational component associatedwith the second inner body; and (iv) a first end of the second outerbody comprising a first pivotal coupling whereby the second body segmentis pivotally coupled to the first body segment; (c) a third body segmentconfigured to be disposed inside a cavity of a patient, the segmentcomprising: (i) a third outer body; (ii) a third inner body rotatablydisposed within the third outer body; (iii) a third operationalcomponent associated with the third inner body; and (iv) a first end ofthe third outer body comprising a second pivotal coupling whereby thethird body segment is pivotally coupled to the second body segment; and(v) a second end of the third outer body comprising a second matingcomponent configured to be coupleable with the first mating component.13. The device of claim 12, wherein: (a) the first outer body comprisesa first outer opening and the first inner body comprises a first inneropening, wherein the first inner body is rotatable to position the firstouter opening and first inner opening in communication, whereby thefirst operational component is accessible; (b) the second outer bodycomprises a second outer opening and the second inner body comprises asecond inner opening, wherein the second inner body is rotatable toposition the second outer opening and second inner opening incommunication, whereby the second operational component is accessible;and (c) the third outer body comprises a third outer opening and thethird inner body comprises a third inner opening, wherein the thirdinner body is rotatable to position the third outer opening and thirdinner opening in communication, whereby the third operational componentis accessible.
 14. The device of claim 13, wherein: (a) an interior ofthe first outer body is configured to be fluidically sealed when thefirst outer opening and the first inner opening are not incommunication; (b) an interior of the second outer body is configured tobe fluidically sealed when the second outer opening and the second inneropening are not in communication; and (c) an interior of the third outerbody is configured to be fluidically sealed when the third outer openingand the third inner opening are not in communication.
 15. The device ofclaim 12, further comprising a force mechanism associated with the firstand second pivotal couplings, the force mechanism configured to urge thefirst and second mating components together.
 16. The device of claim 15,wherein the force mechanism comprises a first spring component operablycoupled at the first pivotal coupling and a second spring componentoperably coupled at the first pivotal coupling.
 17. The device of claim12, wherein the first, second, and third operational components are allseparately chosen from a group consisting of an imaging component, anoperational arm component, a sensor component, and a lighting component.18. The device of claim 12, wherein (a) the first operational componentcomprises a first operational arm component; (b) the second operationalcomponent comprises a lighting component and an imaging component; and(c) the third operational component comprises a second operational armcomponent.
 19. The device of claim 18, wherein the first operational armcomponent comprises a cautery and the second operational arm componentcomprises a grasper.
 20. A medical system comprising: (a) the segmentedmedical device of claim 12, the device comprising (i) an imagingcomponent; (ii) an operational arm component; and (iii) at least onedevice magnet; and (b) an external visualization controller configuredto be positioned outside the cavity of the patient, the controllercomprising: (i) an image display component in communication with theimaging component; (ii) at least one arm controller component incommunication with the operational arm component; and (iii) at least oneexternal magnet configured to magnetically couple with the at least onedevice magnet.